title: Low serum concentration of obestatin as a predictor of mortality in maintenance hemodialysis patients.
abstract: Obestatin, a proposed anorexigenic gut hormone, has been shown to have a number of beneficial cardiotropic effects in experimental studies. We hypothesized that obestatin alteration in hemodialysis patients may link to clinical outcomes. This cross-sectional study with prospective followup for almost 4 years was performed on 94 prevalent hemodialysis patients. Obestatin, leptin, proinflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin-6, and various nutritional markers were measured. Patients with low obestatin levels, defined as a level less than median, had a worse all-cause mortality and cardiovascular mortality. The crude all-cause (HR 2.23, 95% CI 1.17 to 4.24) and cardiovascular mortality hazard ratios (HR 4.03, 95% CI 1.27 to 12.76) in these patients continued to be significant after adjustment for various confounders for all-cause mortality. Across the four obestatin-TNF-α categories, the group with low obestatin and high TNF-α (above median level) exhibited a worse outcome in both all-cause mortality and cardiovascular mortality. Clinical characteristics of patients in low obestatin high TNF-α group did not differ from other obestatin-TNF-α categorized groups. In summary, low serum obestatin concentration is an independent predictor of mortality in prevalent hemodialysis patients. Novel interactions were observed between obestatin and TNF-α, which were associated with mortality risk, especially those due to cardiovascular causes.
authors.affiliation: Nephrology Division, Assaf Harofeh Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, 70300 Zerifin, Israel.
authors.forename: Ilia
authors.initials: I
authors.lastname: Beberashvili
authors.forename: Inna
authors.initials: I
authors.lastname: Sinuani
authors.forename: Ada
authors.initials: A
authors.lastname: Azar
authors.forename: Hadas
authors.initials: H
authors.lastname: Kadoshi
authors.forename: Gregory
authors.initials: G
authors.lastname: Shapiro
authors.forename: Leonid
authors.initials: L
authors.lastname: Feldman
authors.forename: Judith
authors.initials: J
authors.lastname: Sandbank
authors.forename: Zhan
authors.initials: Z
authors.lastname: Averbukh
mesh_terms: D015415:Biomarkers / Q000097:blood; D018376:Cardiovascular Abnormalities / Q000097:blood / Q000150:complications / Q000401:mortality*; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000401:mortality; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000401:mortality*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D054439:Ghrelin; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha